| NPI | 1174848147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease (Licence: FL ME106168) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N2427) |
| 207R00000X Internal Medicine (Licence: FL ME106168) | |
| 207RI0200X Internal Medicine Infectious Disease (Licence: TX N2427) | |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2017-11-14 |